My goal as Secretary is to make the Department of Veterans Affairs the No. 1 federal agency for customer service. You can’t be No. 1 in customer service without talking to your customers, so I’m taking every opportunity to hear from Veterans and answer their questions — in town-hall meetings, at VSO conventions, and in personal conversations with Veterans’ representatives and VSO leaders.

Recently, I had the opportunity to meet Ron Brown, President of the National Gulf War Resource Center. Ron and I served in the same company of the 82d Airborne Division: Charlie Company, 1/504th. I was just a few years ahead of him.

Ron’s a Veteran of Operation Just Cause and Operations Desert Shield and Desert Storm. He struggled for years to have his claim of Gulf War-related disability approved by VA and has since dedicated his life to helping other Veterans with the same difficulty.

He asked if I would answer a few questions about VA’s treatment of Veterans with Gulf War illness, and of course I jumped at the chance. To make the answers available to Veterans as soon as possible, we decided to post full responses to them here on this blog.


Ron Brown: After many years of Desert Storm Veterans being told Gulf War Illness was psychological, and with research finally showing it to be physiological, what is the VA’s official statement and stance on Gulf War Illness in 2015?

Secretary Bob McDonald: VA physicians have been treating Gulf War Veterans for many years with symptoms like fatigue, chronic pain, cognitive/memory problems, respiratory problems, digestive difficulties, skin rashes and sleep problems. Some of these symptoms are due to well-known, diagnosable medical conditions, but 25 to 30 percent of Gulf War Veterans exhibit a chronic multisymptom illness (CMI), which has been called “Gulf War illness.”

One of the difficulties with diagnosing and treating this condition is that it has been defined in many different ways. To address that problem, we asked the Institute of Medicine (IOM), known as the National Academy of Medicine as of 7/1/15, to study the issues and recommend alternatives. Last year, the IOM released its report, recommending that we use the “Kansas” and Centers for Disease Control and Prevention (CDC) definitions for the condition. VA has concurred with that recommendation and encourages VA researchers to use these definitions.

The IOM also recommended that we use the term “Gulf War illness” instead of CMI, but CMI appears so frequently in literature on the subject that we don’t want to abandon it completely just yet. We now prefer the term “Gulf War illness presenting as chronic multisymptom illness.” We expect that the terminology could change again as our understanding of the illness evolves.

Brown: What can be done to ensure that all VA primary care providers (PCP) are properly trained in the specific issues that relate to treating Desert Storm Veterans?

McDonald: We are currently developing a deployment health roadmap and toolkit to ensure that Veterans’ health concerns are effectively addressed by Patient Aligned Care Teams (PACT). The toolkit will include educational materials and a Clinical Practice Guideline (CPG) for Gulf War CMI Veterans, their families and the clinical team. Both the roadmap and the toolkit will be available to all clinical teams on the PACT Primary Care website. They will also be part of annual PACT online education highlighting the key knowledge areas for the management of post deployment health, including military service-related environmental exposures and CMI and use of the CMI CPG.

The deployment health roadmap could also be incorporated into the educational efforts of many other programs such the Post-Deployment Integrated Care Initiative (PDICI), the War Related Illness and Injury Study Centers (WRIISC), the Office of Public Health, the Employee Education System’s Gulf War Veteran’s Health Initiative and the VA eHealth University.

Gulf WarBrown: Many Veterans contact the NGWRC about how they must bring in information on issues concerning Gulf War Illness to their PCPs. We also hear from many Veterans that their PCPs have never heard of VA’s War Related Illness and Injury Study Centers (WRIISC), which specialize in toxic and environmental exposures. How do we make sure that all PCPs are aware that the WRIISC is out there and available for Veterans who have suffered toxic exposure from their service?

McDonald: The WRIISCs publish and distribute a newsletter, WRIISC Advantage, three times annually to more than 4,500 individuals. We are looking at broadening the newsletter’s distribution list and are continuing to develop the network of PACT/PDICI Deployment Health champions across VA to provide more points of contacts, local expertise and clinical liaisons between the field and the WRIISCs. The WRIISCs have already trained more than 30 PDICI champions from across the country to take the lead in facilitating implementation of WRIISC recommendations.

Among other efforts to ensure that primary care providers know about WRIISC, we host webinars and VeHU presentations on the functions and role of WRIISCs, and we use Community of Practice and PDICI calls to orient new team members and update training for teams over time. VA’s Office of Academic Affiliations has also developed the Military Health History Pocket Card, which has been widely distributed both within VA and to the broader medical community.

We have also realigned the Office of Public Health to work in close collaboration with Patient Care Services in VHA, which will enhance sharing of the best scientific information about the health effects of exposures with practicing clinicians.

Brown: Would the VA be willing to look at adding another WRIISC, perhaps in some place like Minneapolis? This would be a closer fit for Veterans in the Midwest, and they have top-notch research capabilities.

McDonald: VA is certainly willing to consider this request to add a new site for the WRIISCs. We share Gulf War Veterans’ enthusiasm for the fine work our VA team is doing at the three WRIISC sites: Palo Alto, Calif.; Washington, D.C.; and East Orange, N.J. Eligible Veterans with symptoms that might be deployment-related can be referred by their PCP for a comprehensive clinical evaluation at the WRIISC closest to where they live. You can find more information on the WRIISC program and how to refer patients at www.warrelatedillness.va.gov.

Gulf WarBrown: Can you explain the difference between DoD and VA when it comes to recordkeeping of service records on exposures that occurred during Operation Desert Storm? Many Desert Storm Veterans think that the VA sets the exposures, when in fact the VA bases their decisions on information from DoD.

McDonald: That’s true. VA does not collect exposure data. That’s not within our mandate. We rely instead on DoD for information related to deployment locations and environmental sampling of air, water and soil. VA and DoD continue to work on a project to make it easier for us to access DoD’s environmental data and estimate an individual Veteran’s exposures. We’re also still working with DoD on the Individual Lifetime Exposure Record, or ILER, which would address this question if implemented.

Brown: With all of the pilot research that has been conducted showing promise in so many different areas of Gulf War Illness research, how can we get VA to fund more follow-on research on a larger scale to verify findings from pilot studies, find our Veterans long-overdue treatments or cures, and assist them in obtaining benefits and compensation?

McDonald: VA evaluates results from pilot projects—usually involving a small number of participants—so as to plan larger studies most likely to lead to new treatments. We continue to expand our research and surveillance of Gulf War issues. For example, we’re working to expand pilot studies to multi-site studies before launching them nationwide.

Brown: How is VA’s Office of Research and Development (ORD) working with DoD to address Desert Storm Veterans’ concerns over exposures to chemical weapons as well as particulate matter and the other toxins VA has listed on its website?

McDonald: ORD and VA’s Office of Public Health (OPH) continue to work with existing VA-DoD data sharing agreements to address this issue and are always looking to establish additional new agreements when needed. DoD has developed a plan to evaluate Operation Iraqi Freedom (OIF) Veterans who were exposed to chemicals and chemical weapons, and VA subject matter experts are working with DoD as the exposed Veterans are identified. Particulates and other airborne hazards are being addressed by the Airborne Hazards and Open Burn Pit Registry, which is being coordinated by OPH. This Registry allows OIF and Operation Enduring Freedom (OEF) Veterans to register online. Veterans of Operations Desert Shield and Desert Storm are also eligible because they were deployed to the same geographic region as OIF Veterans.

Brown: For claim issues, why are not all the VA regional offices (RO) on the same page when it comes to rating claims, when all are working from the same set of laws. A better claim process at the RO level would in turn reduce the amount of claims at the Board of Veterans’ Appeals (BVA). For claims that are approved, why is it taking so long to get dependents added to claims?

McDonald: Disability claims based on Gulf War service are evaluated on a case-by-case basis under current statutes and regulations regardless of which RO is adjudicating the claim. Determining whether a claimed disability is an undiagnosed illness or a medically unexplained chronic multi-symptom illness (MUCMI) often requires a specialized VHA medical evaluation, and variations in service-connection grants for claimed disabilities generally reflect differences in the medical or lay evidence.

In the past year, our ROs have made outstanding progress in reducing the backlog of benefit claims, shrinking the backlog by over 80 percent. It has taken a lot of overtime, but we’ve also automated much of the work, including the processing of claims for non-rating issues such as dependency. We are now using an automated rules-based processing system that improves the processing rate of dependency claims and allows claimants to submit dependency claims using eBenefits, VA’s self-service internet portal. This saves RO employees time so they can focus more on adjudicating disability claims. It also serves Veterans better and quicker. Most Veterans who submit online dependency requests receive payments in less than one day.

Brown: What can VBA do to better train ROs on Gulf War-related claims since they have such a high denial rate?

McDonald: VBA’s training and guidance to both RO and VBA quality-review personnel emphasizes a liberal approach to providing Gulf War Veterans with VHA medical staff to ensure decisions on their claims are made on the basis of the best possible medical evidence. That training and guidance is continually updated as needed to ensure that all Veterans receive consistently careful and informed consideration, including Veterans who submit Gulf War Illness disability claims.

Brown: What can be done to better train C&P examiners on chronic multiple symptoms Gulf War Veterans have since so many examiners do these exams incorrectly and do not follow Training Letter 10-01, the training guideline for raters and C&P examiners?

McDonald: First, I should explain: A denial of service connection does not mean the medical examiner has made a mistake. The physical examination is only a part of the evidence considered in determining if benefits are awarded. There are other facts to consider. For example, as stated in Training Letter 10-01, for a Veteran to qualify for disability for an undiagnosed illness, the illness must have appeared while the Veteran was in the Gulf, or it must have become at least 10 percent disabling during the applicable presumptive period. A physical examination can’t satisfy those requirements. In such cases, the submitted lay statements may be decisive.

VA provides several training courses on Gulf War and Environmental Exposure for clinicians. One is a training program called Caring for Gulf War Veterans, which is a Web-based course providing overviews of the Gulf War experience, VA and DoD programs available for Gulf War Veterans, and common symptoms and diagnoses of these Veterans. The course emphasizes the most recent information from clinical and scientific studies of Gulf War Veterans’ Illnesses to ensure clinicians are properly trained.

Caring for Gulf War Veterans is being released as a part of the Veterans Health Initiative, a comprehensive program of continuing education that recognizes the connection between certain health effects and military service, emphasizing better military medical histories for Veteran patients to provide them with the best available care.

Training is also available for various types of environmental exposure such as Agent Orange, ionizing radiation, shipboard hazards or Gulf War service.

The Office of Disability and Medical Assessment has also developed a Web-based training course on the Gulf War examination in collaboration among VBA, the Board of Veterans’ Appeals and VA’s Employee Education System. This course provides an overview of the medical examination process for Gulf War disability claims, with updated information and procedures for preparing, conducting, and documenting a C&P Gulf War general medical examination sufficient for adjudication purposes.

Brown: What steps can be taken to ensure presumptive conditions for Desert Storm Veterans under Sec 3.317 are not denied at the regional offices, which is happening now?

McDonald: The presumptive conditions associated with Gulf War service include the MUCMIs: chronic fatigue syndrome, fibromyalgia and functional gastrointestinal disorders, as well as the recently added list of infectious diseases. When these conditions are claimed, and there is sufficient evidence supporting a chronic and current disability, service connection is warranted if the required Gulf War service has been established. If there is an unresolved medical question about the presumptive condition or about whether a claimed disability is undiagnosable, VBA will obtain a medical examination or medical opinion to resolve the issue. Generally, RO denials occur when the evidence does not support the existence of a presumptive condition or undiagnosed illness.

Brown: Primary care providers are supposed to fill out disability benefits questionnaire (DBQ) forms for Veterans. Why are some not willing to doing it? And what can be done to address this matter in the different VA hospitals around the country?

McDonald: Disability examination is a central VHA mission. It is VHA policy that disability benefits questionnaires be used to provide medical evidence in support of any Veteran’s claims. (See VHA Directive 2013-002, Documentation of Medical Evidence for Disability Evaluation Purposes).

Some restrictions apply as to who can complete a DBQ. Veterans may ask their PCPs or specialists to complete a DBQ for conditions that are already diagnosed and documented and for which the PCP or specialist is treating the Veteran. DBQs can be completed during a routine office visit when there is sufficient time and the medical information is available. They can also be completed outside of an office visit, or an appointment can be scheduled for completion.

If the VHA PCP is not confident about completing a DBQ or finds the DBQ requires diagnostic testing not indicated in the history or current symptoms, the PCP must not complete the DBQ. If the PCP is not able to complete the DBQ, the PCP should discuss the reason with the Veteran and assist the Veteran in filing a claim for disability benefits. That may include directing the Veteran to the Veterans On-Line Application (VONAPP), to the VA benefits call center at 1-800-827-1000, to a Veterans service organization (VSO) representative or to other local resources. Veterans presenting to the PCP with multiple DBQs or with specialty-related DBQs may also be directed to the VONAPP, to the VA benefits call center, to a VSO representative or to other local resources. Issues related to the DBQ process should be directed to the facility director’s office or patient advocate.

Gulf WarBrown: We met last October to discuss the presumptive conditions the National Gulf War Resource Center (NGWRC) has been trying to have added for Desert Storm Veterans. Is there any information on these presumptive conditions you have at this time you would like to share with our Desert Storm Veterans?

McDonald: VA is committed to assisting Gulf War Veterans to the fullest extent possible under current laws and consistent with medical science. The NGWRC has suggested the inclusion of brain and lung cancers, migraine headaches, gastroesophageal reflux disease (GERD), and dyspepsia as presumptive conditions associated with Gulf War service. Dyspepsia is already considered under the MUCMI of functional gastrointestinal disorders, and service connection for GERD can be established as associated with Gulf War service where the evidence specific to a particular case supports such a finding. Regarding brain cancer, lung cancer and migraine headaches, there have been nine Institute of Medicine reports in the Gulf War and Health series since 2000, and none have provided scientific support for adding these suggested conditions to the presumptive list. As a result, they have not been added. If supporting scientific evidence becomes available in the future, VA will reconsider this decision.

Brown: The NGWRC has brought many problems and issues to you and other VA officials on behalf of our Desert Storm Veterans, but at the same time, we also provide solutions for all issues we bring forward. Can you tell our Desert Storm Veterans a little about the working relationship the NGWRC has developed with the VA?

McDonald: VA highly values our ongoing collaborative relationship with the NGWRC as we all seek to better inform and care for Gulf War Veterans. The leadership of the NGWRC has gone to great length to regularly inform VA of the issues most important to Gulf War Veterans. VA’s Spring Gulf War Newsletter is one example of this partnership

Brown: If you could tell one thing to Desert Storm Veterans or any Veterans who have lost hope in the VA, what would it be?

McDonald: I’d like them to know that this is a new day at VA, for both Gulf War Veterans and all Veterans. For Gulf War Veterans, we have a new chair of our Research Advisory Committee on Gulf War Veterans’ Illnesses – Dr. Stephen Hauser, a neuroimmunologist who chairs the department of neurology at the University of California at San Francisco.

We also have two other new committee members: Frances Perez-Wilhite, a former Army officer who served in Operation Desert Shield in 1990, and Dr. Scott Young, who was a Navy flight surgeon in the Gulf War.

For all Veterans, we have a new Secretary, new Deputy Secretary, and new Under Secretary for Health, Dr. David Shulkin, former president and CEO of Beth Israel Medical Center in New York, where he led a financial turnaround and rebuild of the $1.3 billion organization.

We are making outstanding progress on VA’s three main priorities: we’ve cut the backlog of disability claims by more than 80 percent; we’ve brought Veterans’ homelessness down by a third; and we’re providing more care to more Veterans than ever before. Ninety-seven percent of appointments are now completed within 30 days of the Veteran’s preferred date, 88 percent are within seven days and 22 percent are same-day appointments. Average wait times for completed appointments are four days for primary care, five days for specialty care and three days for mental health care.

We’ve begun a major, department-wide, transformational effort putting Veterans at the center of everything we do. We call it MyVA because that’s how we want Veterans to think of us.

The first of our five MyVA objectives is improving the Veteran experience at VA, and that starts with listening more to what Veterans say. We want to hear from Gulf War Veterans. We welcome your participation in our transformation process, and we look forward to working with you to serve all Veterans better.

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Published on Aug. 14, 2015

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12 Comments

  1. Michael Cox September 2, 2015 at 4:13 pm

    This is how the “Choice Program” works in the real world.
    Aug 14, 2015, went to an appointment and the Dr. wanted follow ups twice a week for eight weeks. The clerk said the next available one was Sept 30, six weeks away. I was then told to call Vets Choice on Aug 28th for an outside appointment. As of Sept 2nd Vets Choice still had no referral and could not offer any help. Called back to the clinic and was given an appointment for Sept 21st, five weeks from the original request. No referral to Vets Choice was going to be given and no reason offered.
    So, Vets Choice is designed to prevent us from waiting more than 30 days. I will have waited five weeks for the first follow up that should have happened within 7 days.

    On Aug 22, 2015 I had another appointment in a different clinic. The Dr. requested an MRI for a surgery that is needed asap, not life threatening but needed very soon. The next MRI appointment is not until late November, 3 months. When I called the Radiology Dept. for the referral to Vets Choice the call goes directly to voice mail. Three days and three calls later still only voice mail and no return call.

    If anyone wonders why we hate this system just become a patient, you will soon know.

    Oh yes, during all this time I am restricted to a bed most of the time due to a very high level of pain, 7-9/10.
    I am a 100% disabled combat vet.

  2. Keith Daniel August 31, 2015 at 11:50 pm

    First thanks to Secretary Bob and Mr. Ron Brown but let be serious we all know the majority of the VA PCP are a joke and it’s a shame we have to use private Dr. for adequate medical treatment. I’m a desert Storm Vet and get treated like less then humane by my PCP and I see why they have VA police because this level of care is ridiculous. The system as a whole is design to compensate as less as possible, example look how long it took for Gov to recognize agent orange 40+yrs the million dollar question is how many vets have died before gov start to realize the chemical used in Vietnam now how many gulf war will passed away before they recognized the chemical used in the Middle East. I been fighting this war at home with the VA for 20+ yrs off and on to my fellow vets never ever give up like I did go and get what is due us.

  3. Judith Ridge August 25, 2015 at 9:50 am

    My son is a gulf war vet. He has suffered unimaginable pain for over 20 years. Some days he can’t walk or move his hands. Some days the pain is beyond description. He has gotten zero help from the VA. They say he has gout. He doesn’t have gout, his joints swell all the time, gout comes and goes, doesn’t stay for years. He is seeing a civilian Dr now and a VA mental health dr for PTSD. It is time the government helped these soldiers. They sent our young men to Iraq and the gas that was released from The enemy. Now the VA doesn’t want to acknowledge Gulf War Syndrome at all. My son gets no money from the VA. He lives on a very small social security disability check. Someone needs to change this VA policy of ignoring these vets.
    He was hospitalized in a civilian hospital for a week this year when he was totally unable to take even one step, or stand alone. The VA sends him home and gives him an appointment for 6 months for another review. This has been the procedure for over 20 years.

  4. Haffese Ali August 24, 2015 at 9:13 pm

    I am a Vietnam-Era Veteran and for the last 20 years I was fighting for my claims. After all this time I was told by the Regional office in New York that the claims filed for are not in my Military medical records. I would like to know what I can do to retrieve my missing files. I was also hospitalized for one week while on active duty and those records are also missing. It is very frustrating for me as I’m also suffering from PTSD and not everyday is a normal day for me. I would appreciate it very much if anyone have an answer for me of what I can do to find my missing records.

  5. Tracy McAdams August 24, 2015 at 3:14 pm

    Yes, VA does treat for these conditions however Th RO’s do not recognize that treatment as being Gulf War related despite evidence proving that the conditions ARE related to such. I have evidence of this as I am fighting my husbands case with him and in the end, we had to hire an attorney which cost us money that we do not have simply because the RO chose to be a medical specialist. I make that statement not arbitrarily but based on his denial information, this particular RO went so far as to make the statement “it was due to a fight” for an issue that had no reference what-so-ever in my husbands records. It was a self-based assumption on the part of the RO. This should never happen under ANY circumstance.

    I wish you would/could find the time to sit and talk to the veterans that literally have been screwed by the so called “improved system”.

    My husband was sent before the MMRB and was put out of the Army after 12 years of active duty. He was in Desert Shield, Desert Storm, Free Kuwait and several others. As soon as he returned in 1992 he was put out. It took until 2008 to get that tour in his records and he was denied treatment up to that point because “he was not there”. After finally getting that in his records and despite his physicians, for the most part, have been very specific he was just recently denied on everything as “not warranted as gulf war illness”. He was the last of them to leave as he returned on the ship with the equipment which means he was there during the fires burning, there during the burn pits and there during pretty much all of it as is CLEARLY INDICATED by his service records & DD215 which they used when we were finally able to prove his time over there.

    Some things have changed, but not as far as this goes and for an RO to base his or her decision on personal assumption should NOT be tolerated under any circumstance. Especially when everything is black & white right in front of their face. It doesn’t help that the C&P examiners do not read in the records or even perform an examination. His most recent one the examiner stated his flexion in several different areas was at a specific degree, yet she never performed these necessary tests. The examiner also noted that he was able to walk on his tippy toes, despite the fact that A. He was not asked to do this and B. His L big toe knuckle was removed making this simple feat impossible to do and finally C. He has severe neuropathy in both feet and can barely walk much less in any form that would cause him to become unbalanced as he falls. Yes a complaint was put in pertaining to this particular examiner to the patient advocate who does not ever get back with the patient for any type of complaint (several veterans at our local VA have put in complaints/requests but nothing has ever become of them). I know he received the complaint as I, personally, mailed it “signature required”.

    While our MH clinic is bar none, there are very few other physicians that actually give a rats behind about anything. I don’t know all of the primary physicians but I do know two that sincerely care about their patients as well as two that couldn’t care less. It’s sad, no it’s less than sad and it’s not getting any better.

    So when the patient advocate is of no service (because of no response) where do we go next as a veteran? I know VA will eventually have to answer for the unprofessionalism of the C&P examiner as a letter was also sent to the Medical Review Board in the state she was licensed. Hopefully that will help other veterans but it does nothing for my husband.

    This is not just a complaint it’s an attempt to help ALL veterans so they can be professionally examined, the claims professionally looked at with no personal medical assumptions being made without actually seeing the veteran making the claim by the RO (which is rediculous I know, but so is their ability to make medical assumptions) and perhaps maybe even help remove those that don’t care about the veterans and replace them with true professionals.

    Thank you

  6. Jose Alag August 24, 2015 at 11:22 am

    How about those pill that I was given, and the shot they give us it’s called Am-tract shot do they have side epic too. Because My upper body are hurting And my daughter have a skin rushes is that possible?

  7. Michael P. Dykes August 20, 2015 at 10:57 am

    While I appreciate Sec McDonald talking with Mr Brown, and publishing in the VA blog, the VA has been woefully inadequate in dealing with this issue. The Gulf War, and illness I’ve suffered as a result, have been the defining events in my life, and I still don’t feel like I’m being listened to at my local CBOC.

  8. Ronald Brown August 20, 2015 at 8:29 am

    I would like to thank Secretary Bob for his time on this interview. We are indeed making progress with the VA even if it’s in baby steps at least those steps are in a positive direction. Looking forward to meeting with Secretary Bob, Dr. Shulkin and Dr. Clancy in our September meeting to address the Benzene presumptive we have ask the VA to add for Desert Storm veterans.

    Ronald Brown

    President
    National Gulf War Resource Center

  9. Michael Shill Sr August 18, 2015 at 5:10 pm

    The questions very well placed, and the answers sound very promising. There remains one more factor, the VARO’s all still operating with the attitude “Business as Usual” there is a need to make changes. VA employees are not accomplishing the jobs they are charged with, and in fact not following the VA regulations or directives, yet still receiving bonus’s and promotions for adjudicating Veterans claims for benefits. One example: Seattle Special Mission Project Officer – Disability Rating Activity Site: Michael failed to follow VARO directive’s for processing Provisional Rating Decisions when VA authorized exams were requested prior to the final decision date May 17, 2013 when his position at the time was Veterans Service Center Manager (VSCM) of the Seattle Regional Office. However was promoted in Oct 2013 to the present position.

  10. Chief Points August 14, 2015 at 10:57 pm

    The VA has failed miserably to address Gulf War vets concerns. It’s painfully obvious to those of us to suffer from Gulf War Illness that there isn’t enough emphasis on ensuring providers are knowledgeable about our plight. There has not been one single instance where I haven’t had to inform my provider of programs existence (Even VA sponsored programs). I’ve ended up in countless emergency rooms due to the VA’s inability to address our concerns, and even ended up with emergency surgery which stemmed from symptoms being completely ignored by providers. Symptomatic Gulf War vets have to basically be their own doctor if they hope to find any relief at all. On top of this, Pain Management programs offered by VA hospitals are woefully inadequate. All points made by the Secretary sound good on paper, but unless they trickle through the entire VA system, they are worthless babble.

  11. Dr Dave Hatfield August 14, 2015 at 4:57 pm

    I appreciate Secretary McDonald taking the time to respond to the NGWRC questions, and thank Ron Brown for putting together such a good list of questions to ask the Secretary. Unfortunately, too much of this sounds like the same old same old. The web-based training, the pocket cards, the newsletters, and all the rest are already out there or have already been tried, but the word just isn’t getting to the C&P examiners, the PCPs, or the RO claims deniers or DRO reviewers. Or if it is getting to them, they either don’t understand it or aren’t paying attention to it, as evidenced by the far too high denial rate, the continued reports of problems with C&P exams, and reviews of claim denial letters.

    I don’t want to dismiss everything Secretary McDonald said; VA is working on some very positive things and some are having very positive effects in the system, but I haven’t seen much improvement in the Gulf War VHA, VBA, or ORD-OPH areas related to Gulf War Illness. The DC WRIISC has been doing a terrific job, but I hear almost nothing about the Palo Alto WRIISC. The East Orange WRIISC has had a few key providers who have written some very disparaging articles about Gulf War Illness, and I haven’t heard the same good things coming out of there as from the DC WRIISC.

    So this is the case, again, where I think Secretary McDonald’s staff provided him with the answers they think he wants to hear, and they all sound like they respond to the questions. But they are the same answers we’ve been getting for years with no significant improvement in our care or in the handling of our claims. It’s the standard little dance all huge bureaucracies do – the boss can’t possibly know all the details of the far-end outputs, so he relies on his chain of leaders to provide him the information. Secretary Bob’s leaders give him information that make them look good, and some of them may even believe all this is truly effective, but they don’t, or won’t, see the true outputs based on the numbers and the actual output reviews.

    In any case, thanks again to Ron Brown for asking good questions and to Secretary Bob McDonald for taking his valuable time to put together the responses. I do know he’s been responsive to Ron and that he really cares about trying to get this right!

    Gulf War Veterans
    25 years
    1990-2015
    Still Waiting for a Cure (or a Cause, or a Treatment)

  12. James A. Bunker August 14, 2015 at 4:23 pm

    Secretary McDonald,

    I would like to thank you and your staff in taking the time to reply to our questions from our members.
    I would also like to that you for working with us in getting some changes make to improve the care to veterans and soon the changes in the VBA.

    As we all know we are all here to help the veterans.

    This is a hard illness to understand, but the war was one of the most toxic. As the list does show over 20 different toxins and no one has ever looked at combining them in a human even two at a time.

Comments are closed.

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